Facility Request

This form must be completed and "digitally signed" before any activity will be reviewed for placement on the church master calendar. All properly completed forms will be reviewed within seven calendar days and a response provided to the requesting party. No request will be considered and/or approved more than six months in advance of the activity requested. Arvada Covenant Church activities have priority use of our facilities. Therefore, we reserve the right cancel any previously approved event up to 30 days prior to the event date. Submission of a facility request does not guarantee approval.

Please fill out all applicable fields.

For: (person/group)*
Type of Activity:*
Arvada Covenant Member:*
Yes    No
Tax Exempt:*
Yes    No
Non-Profit 501 c3 Organization:*
Yes    No

Requested Times:
Begin Setup: *
Activity Start Time: *
Activity End Time: *
Leave Premises Time: *
One Time
Activity Date:

Recurring Start Date:
Recurring End Date:
Recurring Days: Sunday   Monday   Tuesday   Wednesday
Thursday   Friday   Saturday
Recurring Explanation:

Requested Building Use:
Please note that rooms will be assigned by availability.
Upper Level Rooms:
Choir Room
Conference Room
Worship Center (Sanctuary)
Upper parking lot

Lower Level Rooms:
Family Life Center (Gym)
The Hub
Launch Pad**
Student Ministries**
Sustad Chapel
Triangle Room
BBQ Grills
Picnic Tables
Lower parking lot
** Due to the contents of this room, special permission is needed before use approval.
Number of People Expected:*

     Rectangle: Standard Size
     Rectangle: Narrow

Chairs Needed

Audio/Visual Needs:
(Use of sanctuary sound board, light board, or video equipment requires paid church technician)
TV/VCR Combo
DVD Player
Portable Video Projection Unit
Microphones: Handheld Wired
Microphones: Handheld Wireless
Microphones: Wireless Lapel
Music Stands
Overhead Projectors

Child Care / Nursery:
Hours Needed:

Number of Children:

Ages of Children:

Special Needs or Room Arrangements:
You can fax drawings of room set-ups to the church office at (303) 422-7074. Be sure to include your group name, meeting date, and room number in any drawings! Please be sure that all room setups are delivered (fax or in person) to the church no less than one week prior to the event.

Please carefully read the following terms and conditions:

Church Usage Policy:
By signing below the individual/group/organization is applying for a temporary license to use the Arvada Covenant Church facilities. Arvada Covenant Church does not warrant or represent that the property is safe or suitable for the purposes for which it may be used, and I/We acknowledge that the church is providing the property/facility and all appliances on an "as is" basis.

The church will provide no supervision or control over the property when being used by the group. I/We agree to treat the building, grounds, equipment and other church assets with the utmost respect and care. Any loss or damage to the church, the church property or any other church asset will be the responsibility of the group using the facility at the time. I/We agree to fully compensate the church for any required cleanup not properly completed by the group, and to compensate the church for any loss or damage. I/We agree to do so within ten calendar days of receipt of an invoice from Arvada Covenant Church for said cleaning, damages or loss. Unpaid amounts will incur a late fee and will accrue interest at the highest amount allowed by Colorado state law. Rooms and areas other than those specifically requested are off limits and are not to be entered or used. The use of candles is prohibited unless specifically authorized in writing by the Church Administrator.

Church decorations, flags, candles, pictures, signs of faith, bibles and other items which depict our Christian faith and belief system may not be removed, moved, hidden, concealed, modified or altered at any time for any purpose. Exceptions to this must be in writing from the church administrator and will be granted only under extenuating circumstances.

By signing below I/We also accept sole responsibility for complying with all applicable copyright laws. We also accept sole responsibility for collection of any applicable sales taxes and will indemnify the church for any taxes it may be assessed as a result of our use of the facility.

Policy when children are in attendance: A minimum of two adults is required to monitor the foyer, hallways and bathrooms when children are involved in a scheduled activity. The church will provide monitors at the rate of $25.00 per hour for each monitor if your group is unable to meet this minimum. Due to the liability issue no "childcare" will be provided or allowed for outside groups. Only children directly involved in the activity will be permitted in the building. I/We warrant that we have exercised a high degree of care in conducting background investigations on all persons who will have access to minors to ensure their suitability for working with or being present with minors during our use of the facility. We also warrant that we will exercise a high degree of care in supervising all activities involving minors during our use of the facility.

Policy on tobacco, alcohol or use of drugs: Any use of tobacco, alcohol or drugs on the premises and grounds is strictly forbidden at all times.

Allergies policy: The use of latex balloons and latex gloves is strictly prohibited on church property. Due to severe allergies the church strongly discourages the serving of any food product containing peanuts. Any food products containing peanuts or peanut ingredients (peanut oil, extract) must be clearly and conspicuously labeled as containing peanut products. No food can be prepared at Arvada Covenant Church that contain peanut ingredients.

Organizational Users: User promises and warrants that it carries liability insurance with a minimum liability occurrence limit of $1,000,000. The User will provide a certificate of insurance to the church at least seven days prior to the date upon which the User begins to use the above described premises. The certificate of insurance will indicate that User has made Arvada Covenant Church an "additional insured" on User's policy with respect to the use by User of the above described premises.

By requesting the use of the building I/We agree to abide by the guidelines and policies of Arvada Covenant Church as described above and pay for any facility or equipment damages and cleaning charges in addition to the fees charged me for the facility use. Full payment is due in advance of the event. Recurring events require advance monthly payments. Fees based upon attendance or hourly rates will be billed at the conclusion of the event.

I/We pledge that the activity being scheduled is not in conflict with the teaching/principles of Arvada Covenant Church as described in the ACC Core Values document. Release and Waiver of Liability: I/We understand and agree that neither Arvada Covenant Church nor its trustees, representatives, employees or agents may be held liable in any way for an occurrence in connection with the activity which may result in injury, harm, or other damages to the undersigned or members of our organization and guests, invited or not. As part of the consideration for being allowed to use your facility, building and grounds as well as all appliances and fixtures in the activity, I/we hereby assume all risk in connection with participation in the activity. I/We further release Arvada Covenant Church, its trustees, employees, agents, or representatives from any damages which may occur while participating in the activity I/We further agree to save and hold harmless Arvada Covenant Church, its trustees, employees, agents, or representatives from any claim by the undersigned member of the Organization, their estates, heirs, or assigns arising out of or participation in any form or fashion in the activity.

I/We further state that I/we are authorized to sign this agreement; that I/we understand the terms herein are contractual and not mere recital; and that I/we have signed this document of my/our own free act and volition. I/We further state and acknowledge that I/we have fully informed ourselves of the content of this agreement and release by reading it before I/we signed it.

Signature of Authorized Representative*
By typing my name here, I acknowledge that this "digital signature" acts just the same as an actual signature and the individual/group will be held liable to the above terms and conditions.
Contact Name*

Phone Number*
Ex: (303) 555-1234

Email Address*

Billing Details:
(If there will be a fee, you will be contacted by an Arvada Covenant staff person before you are billed.)
Street Address